Monitors and evaluates the coding functions to ensure effective and efficient coding operations and compliance with established standards, rules and regulations.
Audits for documentation opportunities to clarify confusing, incomplete or conflicting information and obtain any needed additional documentation if needed.
Assists patient financial services and clinical documentation improvement team members with questions on coding and billing edits.
Serves as a clinical coding liaison. Analyzes and evaluates documentation issues with consultation from the medical staff, clinical staff, CDI team and other departments as needed.
Assists leadership with coordination of iCare initiatives related to the hospital coding department.
Assists with DRG and certain CPT denials from payers as needed and writes appeals as indicated, documenting the denial/audit in denial management tool for tracking and reports
Qualifications
Education
High School Diploma or GED, (Required)
Associates Degree, Healthcare or Related (Preferred)
Experience
5-6 years Acute Care Inpatient (IP) and Outpatient (OP) Coding (Required)
2 years Auditing - Acute Care IP and OP (Required)
1 year Clinical Documentation Integrity (Preferred)
Skills and Abilities
Maintain current working knowledge of ICD-9, ICD-10 and CPT coding principles, government regulation, protocols
Intermediate proficiency with Excel, PowerPoint, Word
Skill in completing assignments accurately and with attention to detail
Ability to adapt to changes in the work environment
Excellent interpersonal skills and team oriented
Ability to communicate effectively in both oral and written form
Licenses and Certifications
Certified Coding Specialist (CCS) - The American Health Information Management Association (AHIMA) Upon Hire (Required)
Registered Health Information Administrator (RHIA) - The American Health Information Management Association (AHIMA) Upon Hire (Preferred) or
Registered Health Information Technician (RHIT) - The American Health Information Management Association (AHIMA) Upon Hire (Preferred) or
Certified Clinical Document Specialist (CD) - Association of Clinical Documentation Integrity Specialists (ACDIS) CCDS Certified Clinical Documentation Specialist or CDIP Clinical Documentation Improvement Professional Upon Hire (Preferred) or
Certified Professional Coder (CPC) - American Academy of Professional Coders (AAPC) Upon Hire (Preferred) or
To learn more about being a team member with Riverside Health System visit us at https://www.riversideonline.com/careers.